Objective:To analyze the status of doctor -patient trust and its influencing factors based on the per-spective of the villagers .Methods:Using purposive sampling method , the selection of the H area as the research site in Beijing , for in the 14 township 80 administrative villages of trust information in the form of questionnaire sur-vey .Results:The 350 villagers were surveyed 301 villagers of village clinics held a positive attitude to the doctor -patient relationship , accounted for 86 .00%;There are 44 villagers of village clinics the middle ground the doctor-patient relationship , accounted for 12 .57%;Only five of the villagers of village clinics have held a denial atti-tude to the doctor-patient relationship , accounts for 3.43%of the proportion of the total .Based on blood kinship relationship between the villagers of village clinics and rural doctors more trust , but the technical level and service ability are the main factors affecting doctor -patient trust .Conclusion:Rural doctors and villagers in the same vil-lage , has a common living environment , interpersonal relationship , morality , interpersonal trust between each other is higher .In clinical activities , formed by the interpersonal relationship with the clinical common existing doctor -patient trust , is essentially interpersonal trust mask a lack of technology .Transformation in the society , how to im-prove the service ability of the village clinic , realize the village clinic real doctor -patient trust is the important connotation of health reform .

Positive end-expiratory pressure (PEEP) is a common method to maintain alveolar patency in patients undergoing mechanical ventilation. However, in patients undergoing tracheotomy, alveolar collapse often occurs due to bedridden, aspiration, and other factors. There is currently no effective means to provide PEEP support for such patients. The application of a high-flow oxygen inhalation device with a PEEP valve was designed to provide patients with continuously adjustable PEEP, which helps to improve the patient's oxygenation and maintain the lung's physiological functions.

Objective    To investigate the clinical efficacy of video-assisted thoracoscopic surgery (VATS) and pleurodesis for spontaneous pneumothorax. Methods    A retrospective analysis of 157 patients with spontaneous pneumothorax undergoing VATS from January 2012 to March 2016 in our hospital was done. According to different treatments, patients were divided into two groups: a group A (65 patients receving pleurodesis, 52 males and 13 females with a mean age of 34.77 years ranging from 17 to 73 years) and a group B (92 patients without pleurodesis, 76 males and 16 females with a mean age of 34.66 years ranging from 16 to 72 years). In the group A 29 patients underwent closed thoracic drainage; while in the group B there were 39 patients. Results    The patients were followed up for 3 months to 4 years. The recurrence rate of the group A was lower than that of the group B, but the difference was not statistically significant. For patients receving closed thoracic drainage preoperatively, intraoperative drainage volume at postoperative 24 h in the group A was more than that of the group B, but postoperative hospital stay was less than that of the group B (P<0.05). For patients not receving closed thoracic drainage preoperatively, drainage volume at postoperative 24 h, total drainage volume, postoperative hospital stay in the group A were more than those of the group B (P<0.05). Conclusion    Pleurodesis can not reduce the recurrence rate of spontaneous pneumothorax. Preoperative closed thoracic drainage combined with intraoperative pleurodesis can effectively reduce postoperative hospitalization; therefore pleurodesis is recommended. If preoperative closed thoracic drainage is not adopted, surgery without pleurodesis can effectively reduce thoracic drainage at postoperative 24 h, total drainage volume and hospital stay and the perioperative results are better; therefore mechanical pleurodesis is not recommended.